MASTER OF MEDICINE (ORTHOPAEDIC)

   1.       Aim

We aim to ensure effective teachings and learning process of the M. Med postgraduate and undergraduate students at the Department of Orthopaedics. A four-year post-graduate training program in OrthopaedicSurgery.

   2.       Background

The School of Medical Sciences, Universiti Sains Malaysia (USM), was established in 1979 to trainundergraduate medical doctors. This evolved into developing post-graduate training in Medicine, whichbegun in 1987. Presently there are more than fifteen specialty post graduate training programmes beingconducted by the School of Medical Sciences, USM.

The orthopaedic unit of Pusat Pengajian Sains Perubatan, Universiti Sains Malaysia was established in Pulau Pinang Hospital in 1981 with the first teaching personnel, Dr Zulmi Wan, who was then sent to Singapore through SLAB program for training. In 1983, the Orthopaedic Department was moved to Kubang Kerian, Kelantan, with Dr. Michael Devas from England was appointed as the first Head of Department. The other lecturers were Dr. Richard Southwood from Australia, Dr. Sudir Kumar (India) and Dr. Abd Wahab Ghani (trainee lecturer). In 1985, Dr. Michael Devas moved to England followed by Dr. Abd Wahab Ghani for further learning and training. The position as the head of the department was taken over by Dr Zulmi Wan and then followed by Dr John Anandhan. This department continued to grow and improved when it started the Orthopaedic Masters Programme in 1991. With this, a new era in Orthopaedic Department with master student’s trainee began. In 2003, the orthopaedic Department was managed according to units; Orthopaedic Oncology Unit, Paediatric Unit, Spine Unit and Hand Unit. We introduced the Arthoroplasty Unit in 2006, followed later by the Sport Unit and the Trauma Unit in 2007 and 2018 respectively.

In 2020, there were an estimated 1100 Orthopaedic surgeons in Malaysia, a little more than half of whom served in public hospitals and universities. This gives a ratio of 3.4 Orthopaedic   surgeons per 100,000 population, achieving developed nation status. There is still a need, however, for more Orthopaedic surgeons to ensure an evenly distributed coverage of services for the entire country.

Every year approximately 80 trainees are recruited into the specialty. They are placed at 30 accredited training centres throughout the country. They are trained by approximately 200 qualified Orthopaedic trainers out of an eligible 440 Orthopaedic specialists and consultants. Training in Orthopaedics is overseen by the Orthopaedic Specialty Committee or OSC (previously known as Conjoint Board of Orthopaedics - CBO) whose members are representatives from the universities offering postgraduate Orthopaedic training, Ministry of Health (MOH) Malaysia, Academy of Medicine Malaysia (AMM) and the Malaysian Orthopaedic Association (MOA). The majority of trainees are sponsored by the MOH or the universities. A small percentage are self-funded, most of whom are from overseas.

The School of Medical Sciences USM, in collaboration of the Ministry of Health of Malaysia, is one of main training centre for Orthopaedic Surgery.

The Department of Orthopaedics has been a major department in the medical school which provides expert treatment for all aspects of musculoskeletal ailments.  There are eight (8) service, teaching and research units. All of our surgeons have specific training and experience in their specialised fields, and each unit is headed by:

1. Head of Orthopaedic Department: Prof. (Dr.) Amran Ahmed Shokri
2. Orthopaedic Oncology and Reconstructive Unit : Prof. (Dr.) Wan Faisham Wan Ismail 
3. Paediatric Orthopaedic Unit : Assoc. Prof. (Dr.) Ismail Munajat
4. Spine and Spinal Cord Rehabilitation Unit : Prof. (Dr.) Mohd Imran Yusof
5. Upper Limb and Microsurgical Unit: Assoc. Prof. (Dr.) Abdul Nawfar Sadagatullah
6. Arthroplasty and Adult Joint Reconstructive Unit : (Dr.)Amran Ahmad Shokri
7. Sports Traumatology and Arthroscopy Unit: Prof. (Dr.) Tg Muzaffar Tg Md Shihabudin
8. Advanced Trauma, Foot & Ankle Unit : Dr. Mohd Hadizie Din
9. Orthopaedic Rehabilitation Unit : Dr. Al-Hafiz Ibrahim

We have 3 dedicated orthopaedic wards (4 Selatan = 36 regular beds + 12 additional beds, 4 Utara = 32 regular beds, including 8 isolation beds, and 2 Zamrud = 25 acute beds). That is a total of 105 beds, excluding the common surgical paediatric wards.

3.       Structure of course (Appendix I) 

The training is divided into 2 phases.

-               Early Phase (year 1): Basic surgical sciences and Trauma in Orthopaedic Surgery 

-               Advanced Phase (year 2,3 & 4): Orthopaedic Subspecialty Clinical Rotations (surgical trainee and elective orthopaedic practice). 

3.1     Curriculum structure phase I

The curriculum is divided into 2 parts. (Appendix II)

a. Phase 1 (Early Phase)

b. Phase 2 (Advance Phase)

3.2      Curriculum structure Advance Phase (specialty trainee in orthopaedic surgery)

   4.        Mode of Teaching and Learning

            Various modes will be used to achieve effective learning objectives.

• Notes, articles, references, and audiovisual material will be prepared together with candidates.
• Lectures and seminar will be given in packages to cover the whole syllabus of orthopaedic surgery.
• Candidate will be actively involved in clinical activities including clinics, ward management, preparation, planning and executing operative procedures, post-operative care and on-call duties in orthopaedic surgery.
• Preparation of case reports, a total of 8 case reports.
• Actively participating in academic and research activities.
• Writing up of dissertation. The title must be specific. The length is about 15,000 words.

5.          Supervision and progress reports

The medical school will appoint a qualified orthopaedic surgeon to be a supervisor for each candidate. The supervisor is responsible for the progress report of the candidate.

6.         Examination and Assessment

            Assessment during the course is divided into 2 parts

• Continuousassessment
• Examination(end of trainingexaminations)

• Year 1, 2 and 3assessments:

• Continuousassessment
  1. Procedure Based Assessment (PBA)
  2. Mini Clinical Evaluation Exercise (Mini-CEX)
  3. Case-based Discussion (CbD)
  4. Clinical reports

• End of Year Review
  1. Trainee Portfolio Review

• Year4 assessment:

• Continuousassessment
  1. Procedure Based Assessment (PBA)
  2. Mini Clinical Evaluation Exercise (Mini-CEX)
  3. Case-based Discussion (CbD)
  4. Clinical reports
  5. Dissertation

6.3.       Exit Examination

Professional examination (End of training assessment) End of year 4;

1. Candidate must pass both components (Theory and 

      Clinical)

1. Theory: Guided essay/BAQ
2. Clinical: OSCE / Clinical Viva/ Long Case / Short Case

6.4        Repeat examination

Failing the professional examination, the candidate may appear in the examination after6 months or 1 year upon approval of the University senate.

7          Entrance Criteria

• Candidatemusthold a recognized medical 
• Candidatemusthave 6 months experience in Orthopaedic surgery after completing thehousemanship 
• Candidatesarerequired to appear for National Selection for Postgraduate Orthopaedic Training (SPOT).

8           Exemption

Candidate can be exempted from 1 case report for every local paper presentation and 2case reports for every international presentation. Candidate can also be exempted from 2case reports for every publication in national journal and 3 case reports for each publication inan international journal.

9.         Duration of Training

The minimum duration of training is four (4) years with a maximum of seven (7) years.

10.      Curriculum and syllabus

Syllabus that will be used is attached (appendix II & III).  However, the syllabus will beupdated from time to time in view of the progress in this field of specialty.

11.      Academic and Teaching Staffs

All academic staffs at the School of Medical Sciences will be involved in teaching activities for early and advanced phase

12.        Administrative committee

The Orthopaedic Department together with Orthopaedic Specialty Committee (OSC) willbe responsible in organizing and monitoring the program, preparing teaching schedule andorganizing seminars pertaining to the program.

13.      Administration of Examination

The Medical School will coordinate and execute all examination. The result will be discussedat the Examination Board before approval by the Medical School Board and the Post-graduate University Board